The clinical application of non-biotype artificial fiver support system to acute liver failure of children

Abstract

Objective To explore the therapeutic effect of non-biotype artificial liver support system (NBALSS) in acute liver failure (ALF) of children by analyzing the data of 16 children with ALF treated with plasma exchange (PE) and continuous venovenous hemodiafiltration (CVVHDF) in the past 2 years.Methods A total of 16 children with ALF in PICU admitted from April 2011 to March 2013 were enrolled in this study.After admission,they were treated for lowering transaminase,removing jaundice,antiinfection,maintaining respiration with mechanic ventilation support and maintaining blood pressure with vasoactive drugs.When patients met the criteria of ALF,the NBALSS was initiated.The CVVHDF were scheduled on the day of admission,and blood chemistry and routine coagulation were checked on the day of admission,day 1,2,3,5 and 7 after NBALSS.The levels of alanine aminotransferase (ALT),total bilirubin (TBIL),prothrombin time (PT),blood urea nitrogen (BUN) and creatinine (Cr) were compared between before and after NBALSS.Alpha-fetoprotein (AFP) was checked on day of admission and 3 days after NBALSS.The data was expressed with Y ± s,and analysis of variance was used for data analysis before and after treatment.Results In 16 ALF children treated with NBALSS,PE time was (7.25 ± 2.25) h,and CVVHDF time was (120.75 ± 33.45) h.On day 2,ALT levels significantly decreased and prothrombin activity (PTA) significantly improved.From day 3,PT significantly shortened,and Cr and TBIL level significantly decreased.On day 5,BUN level decreased significantly.Of them,12 children survived,2 chindren died and 2 children got off from hospital by their own parent decision.Conclusions Compared with conventionally conservative treatment,non-biotype artificial liver support system can improve liver and kidney function and coagulation of ALF children more efficiently,thereby improving the outcome of patients. Key words: PE; CVVHDF; Artificial liver; Non-biotype artificial liver; ALF; MODS; Treatment; Children